WQ0044329_Return Application_20240126

`J�C State of North Carolina
Department of Environmental Quality
t, Division of Water Resources
FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
Dtvblon of water Resources FTA 06-21&SUPPORTING DOCUMENTATION
Application Number: WOOW329 (to be completed by DWR)
All items must be completed or MI application will be returned
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Selma(company,municipality,HOA,utility,etc,)
2. Applicant type: ❑Individual ❑Corporation ❑General Partnership ❑Privately-Owned Public Utility
❑Federal ❑State/County ®Municipal ❑Other
3. Signature authority's name:Phillia McDaniel per 15A NCAC 02T.0106(b)
Title: IW&[m Town Manager
4. Applicant's mailing address: 114 NqM Raiford St
City:&IMA State:NC Zip:27576-
5. Applicant's contact information:
Phone number: 919 L55-9841 Email Address:-pmedaniel(owlma-nc.com
II. PROJECT INFORMATION:
1. Project name:Afield Pump Station 4
2. Application/Project status: ®Proposed(New Permit) ❑Existing Permit/Project
If a modification,provide the existing permit number.WQO(1 and issued date:
For modifications,also attach a detailed narrative description as described in Item G of the checklist.
If new construction,but part of a master plan,provide the existing permit number WQ00
3. County where project is located:Johroto
4. Approximate Coordinates(Decimal Degrees):Latitude: 35.519060 Longitude:78.302920
5. Parcel ID(if applicable): 261414-44-1722(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer Chadp3 Y well PE License Number:044857
Firm:Bohlrg Fagincering NC,PLLC
Mailing address:413Q Parklake Avenue,Suite 200
City:Raleigh State:N� Zip:27612-4462
Phone number: (Qt Q)578-9000 Email Address:SivowellAbohleren¢.com,
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION:
1. Facility Name:Q(;RW)M Pennit Number:NCO030716
Owner Name:jobquton County
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
1. Permit Number(s): WQ004377$. South Selma Resional Pump Station and Forcemain
2. Downstream(Receiving)Sewer Information: 16 inch ❑ Gravity ®Force Main
3. System Wide Collection System Permit Number(s)(if applicable):WQCSQqkW
Owner Name(s):Johnston County
FORM:FTA 06-21 Page 1 of 5

VI. GENERAL REQUIREMENTS
1. If the Applicant is a Privately-Owned Public Utility,has a Certificate of Public Convenience and Necessity been attached?
❑Yes ❑No ®N/A
2. If the Applicant is a Developer of lots to be sold,has a Dcvelgper's Oncrational Airsment(FO,M• nF V)been attached?
❑ Yes []No ®N/A
3. If the Applicant is a Home/Property Owners'Association,has an
and
supplementary documentation as required by 15A NCAC 02T.01 I5(c)been attached?
❑Yes ❑No ®N/A
4. Origin of wastewater:(check all that apply):
®Residential(Individually Owned) ®Retail(stores,centers,malls) ❑Car Wash
®Residential(Leased) ®Retail with food preparation/service ®Hotel and/or Motels
®School/preschool/day care ®Medical/dental/veterinary facilities ®Swimming Pool/Clubhouse
®Food and drink facilities ❑Church ❑ Swimming Pool/Filter Backwash
®Businesses/offices/factories ❑Nursing Home ❑Other(Explain in Attachment)
5. Nature of wastewater: 0%Domestic M%Commercial 30%Industrial($gg I SA NGAC U2"1'.0103120)1
If Industrial,is there a Pretreatment Program in effect?❑Yes ❑No
6. Has a flow reduction been approved under 15A NI AC 02T.0(1Mj)? ❑Yes [:]No
➢ If ve%vroyide a copy of flow reduction aimirovall letter with this application
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f)) Daily Design Flow No.of Units Flow
Existing Flow to Existing Pump Station#4 gay 15,000 GPD
gal/ GPD
gal/ GPD
gay GPD
gal/ GPD
8 GPD
Total 15,000 GPD
a See 15A NGAC 02T.0114fb).!d).!e)(l)and fe)(2) for caveats to wastewater design flow rates(i.e.,minimum flow per
dwelling;proposed unknown non-residential development uses;public access facilities located near high public use areas,
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in G.S.42A 41.
b Per 15A NCAC 02T.0114(c),design flow rates for establishments not identified [in table 15A NCAC 02T.U1141 shall be
determined using available flow data,water using fixtures,occupancy or operation patterns,and other measured data.
8. Wastewater generated by project:Q GPD(per 15A W 'A '02T. )
➢ Do not include future flows or previously permitted allocations
If permitted flow Is zero,please Indicate why:
®Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
All upstream flows are anticipated to be permitted within the next 10 years
❑Flow has already been allocated in Permit Number: Issuance Date:
❑Rehabilitation or replacement of existing sewers with no new flow expected
❑Other(Explain):
FORM:FTA 06-21 Page 2 of 5

VIE. GRAVITY SEWER DESIGN CRITERIA(If Applicable)-02 r•03D5&MM(Cravih 5ewtn):
1. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material
D Section II&ID of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Overstzing lines to meet minimum slope requirements Is not allowed and a violation of the MDC
VIM PUMP STATION DESIGN CRITLRIA(If Applicable)-_qjjAM&MDC(Pump Statloawyorce Mains):
PROVIDE A SEPARATE COPY OF THIS PAGE FOR EACH PUh[P STATION INCLUDED IN IM PR IL'CT
1. Pump station number or name:field Pump Station 4
2. Approximate Coordinates(Decimal Degrees):Latitude:35.519060 Longitude:78,302920
3. Total number of pumps at the pomp station:2
3. Design flow of the pump station: 0.720 millions gallons per day(firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s)per pvmp(s): 5775_gallons per minute(GPM)at 15,53 feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material Notes
8 1,247 PVC FM from Pump Station 4 to connection of Pine Level FM(which
rmhudly connects to South Selma Regional)
If any portion of the force main is Iess than 4-inches in diameter,please identify the method of solids reduction per
MDCPSFM Section 2.01 C.I.b.❑Grinder Pump ❑ Mechanical Bar Screen ❑Other(please specify)
6. Power reliability in accordance with 15A NCAC 02T A305LhN 1):
® Standby power source or ❑ Standby pump
D Must have automatic activation and telemetry- 15A NCAC 02T.0305(hxl)(B)'.
➢ Require;for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day 15A NCACO2T.0305(h)(1)(C):
❑ Portable power source with manual activation,quick-connection receptacle and telemetry-
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ If the portable power source or pump is dedicated to multiple pump stations,an evaluation of all the pump stations'storage
capacities and the rotation schedule of the portable power source or pump,including travel timefrarnes,shall be provided
as part of this permit application in the case of a multiple station power outage.
FORM:FTA 06-21 Page 3 of 5

DC SETBACKS&SEPARA71ONS—(02B.0200& 15A NCAC 02T.0305(1)):
1, Does the project comply with all separations/alternatives found in 1_5A NCAC.02T,0a05(Q&(a)? ®Yea ❑No
15A NCAC 02T.0305 contains minimum separations that shall be provided for sewer s stems:
Setback Parameter* Sepamtlon Required
Storm sewers and other utilities not listed below(vertical) 18 inches
2Water mains(vertical-water over sewer preferred,including in benched trenches) 18 inches
rWater mains(horizontal) 10 feet
Reclaimed water lines(vertical-reclaimed over sewer) 18 inches
Reclaimed water lines(horizontal-reclaimed over sewer) 2 feet
"Any private or public water supply source,including any wells,W S-I waters of Gass I or
Class H impounded reservoirs used as a source of drinlang water,and associated wetlands. 100 feet
"Waters classified WS(except WS-1 or WS-V),B,SA,ORW,HQW,or SB from normal
high water(or tide elevation)and wetlands associated with these waters(see item DL2) 50 feet
"Any other stream,lake,impoundment,or ground water lowering and surface drainage
ditches,as well as wetlands associated with these waters or classified as WL. 10 feat
Any building foundation(horizontal) 5 feet
Any basement(horizontal) 10 feet
Top slope of embankment or cuts of 2 feet or more vortical height 10 feet
Drainage systems and interceptor drains 5 feet
Any swimming pools 10 feet
Final earth grade(vertical) 36 inches
D Ifnoncomplienee with 02T.03Q5(f)or ¢),see Section X.1 ofthis application
•1SA NCAC 02T.0305(a)contains alternatives when separations in 02T.0305{fl cannot be achieved.Please check"yes"
above if these ahematives are used and provide narrative,information to explain.
"Strewn classifications can be identified using the Division's NC Surface Wsrer Clasaifiuttions webnu
2. Does this project comply with the minimum separation requirements for water mains? ®Yes ❑No ❑N/A
➢ if no,please refer to 15A NCAC 18C.0906(f)for documentation requirements and submit a separate document,
signed/sealod by an NC licensed PE,verifying the enteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ®Yes [—]No ❑N/A
➢ Please provide supplementary infrnmation identifying the areas of non-conformance.
D See the Division's for situations where separation cannot be met.
D No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any Suite buffer rules? ®Yes Bain name:Nousg ❑No
If yea,does the project comply with setbacks found in the river basin rules per 15A NCAC QZB.02,Q07 ®Yes ❑No
➢ This includes Trout Buffered Streams per 15A-NCAC 2B,Q2r)2
5. Does the project require coveragelauthorization under a 404 Nationwide/mdividual permits ❑Yes ®No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with 15A NCAC 02T.0105(c)(6)(additional permits/certificatians)? ®Yea ❑No
Per 15A NCAC 02T.0105c)(0,directly related environmental permits or certification applications must be being prepared,
have been applied for,or have been obtained.Issuanoe of this permit is contingent on issuance of dependent permits(erosion
and sedimentation control plans,storrawater management plans,etc.).
7. Does this project include any sewer collection lines that are deemed"high-priority?" ❑Yes ®No
Per I5A NCAC 02T.0402."high-priority sewer"means any aerial sewer,sewer contacting surface waters,
siphon,or sewers positioned parallel to streambankv that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conillct boxes require a variance approval.
➢ If yes,include an attachment with details for each line,including type(aerial line,size,material,and location).
High priority lines shall be Inspected by the permtttee or Its representative at least once every six-mouths and
inspections documented per 15A NCAC 02T.0403(a)(3)or the permittee's individual System-Wide Collection permit.
FORM:FTA 06-21 Page 4 of 5

x CERTIFICATIONS:
1. Does the submitted system comply with 15A NQAC 02T,the hjazaltm Uosi>am(Titcriq fpr the I?amittinu of Puma Stations
and ForcQ Mains(latest mriop),and the Gravity Sewer Minimum as applicable?
®Yes ❑No
If no,for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application.
(VADC 10-14) and supporting documents for review to the Central Office. Annroval of the M9MMt will be issued
macurrently wfth the Rogroval of the n variance apiproval maye subltq to to
review times,For protects reauirine two or more vari; cea or where Site variance is determined by the Division to be as
lkgiQMt portion of the nroied.the fun technical review is reaaired.
2. Professional Engineer's Certification:
I, E attest that this application for Esattield Puma Station 4
(Protestimual13aghccr's name from Appdeatlon Item M.l.) (ProfcdName from Application Item ILt)
has been reviewed by me and h accurate, complete and consistent with the information supplied in time plans,
specifications,engineering calculations,and all other supporting documentation to the best of my knowledge. 1 further
A ttest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
M I?c8ipn Criteria for Gravity Scwcn(]ap t version), and the Krim=I?esilm Criteria for the Fast-Trwk Pgmitrinv
Qfhmn Stations and Form Ms,iw tlatest version). Although other professionals may have developed certain portions of this
submittal package,inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judgod it to be consistent with the proposed design.
NOTE —In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement,representation,or certification in any application package shall be guilty of a Class 2 misdemeanor,which may
include a fine not to exceed S10,000,as well as civil penalties up to$25,000 per violation.Misrepresentation of the application
information,including failure to disclose any design non-compliance with the applicable Rules and design criteria,may subject
the North Carolina-licensed Professional Engineer to referral to the licensing board.(21 NCAC 56.0701)
North Carolina Professional Engineer's seal,signature,and date:
,
3. Apph Certification per 15A NC 02T.0106(b):
I, ,attest that this application for Eastfield Pura Station 4
e AulkO*Name fhm A on Item L3.) (Project Nam hum Application Item 11.1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included,this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non-discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties,injunctive relief,and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this.permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments am not included,this application
package will be returned to me as incomplete.
FORM:FTA 06-21 Page 5 of 5

NOTE In aocordanco with General Statutes -L43-215.6A and 143 215.41i. any parson who knowingly makes any false
statement,representation,or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$1 ,DOO as well as civil penalties up to$25,000 per violation.
Signature: Date:
FORM:FPA 06-21 Page 6 of 5

*, '� 9 .M� State of North Carolina
t Department of Environmental Quality
Division of Water Resources
DIVISIon of w to ucsourr� s Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Selma
Project Name for which flow is being requested: Eastfield Pump Station No. 4
More than one FTSE nray be required for a single project if the owner of the WWTP is not responsible for all pump
stations along llte route of the proposed wastewaterflow.
I. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Central Johnston County Regional Wastewater Facility
b. WWTP Facility Permit#: NCO030716
Allfl'ows are in MGD
c. WWTP facility's permitted flow 9.5
d. Estimated obligated flow not yet tributary to the WWTP 2.068
e. WWTP facility's actual avg. flow 5.507
f. Total flow for this specific request (0.015 already trib to plant,
will take different route to
Buffalo Creek WWPS) _
g. Total actual and obligated flows to the facility 7.5746
h. Percent of permitted flow used 58%actual, 80%w/paper
11. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (B) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity, (Firm/pt), Avg. Daily Daily Flow, Obligated Available
Number) No. MGD MGD Flow,MGD MGD Flow Capacity***
S. Selma 44329 3,881 1.408 0.1928 0.1124 0.2902 1.1028
SEPF 41331 3.4560 1.4446 _ 1.1780 0.006 1,1825 0.26202
Buffalo
40380 6.9120 2.7648 2.2890 0.2099 2.4990 0.265832
*The Firm Capacity(design flaw) of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
**Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(pf) not less than 2.5,per Section 2.02(A)(4)(c)of the Minimum Design Criteria.
***A Planning Assessment Addendum shall be attached for each pump station located
between 1b6•0rojebt connection point and the WWTP where the Available Capacity is<0.
Downstream Facility Name(Sewer): S. Selma Regional WWPS*-
UlA r a C#�S `dry
Page 1 of 6
FTSE 10-18

Downstream Permit Number: WQ0044329
III. Certification Statement:
I Chandra C. Farmer, P.E. certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data, This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capacity to transport and treat the proposed new wastewater.
3
Signor 1Cla Signature ate
Title of Signing Official
Page 2 of 6
FTSE 10-18

Bohler
BOHLERW 4130 Parklake Avenue, Suite
200
Raleigh, NC 27612612
919-578-9000
June 30,2023
Via: Fedex/Electronic Mail
Chris Smith
NCDEQ
Raleigh Regional Office
Water Quality Section
3600 Barrett Drive
Raleigh, NC 27609
Re: Fast Track Sewer Systems Extension Permit
Eastfield Pump Station 4
WQ0044329
Providence Blvd, Selma, NC
Johnston County
BE#NCR211043
Dear Mr. Chris Smith:
Bohier Engineering is pleased to submit on behalf of Adventure Development,the revised Fast Track Sewer Systems
Extension Application for the Eastfield Pump Station 4, application number WO0044329. The pump station will be
located near the intersection of Providence Blvd and US Hwy 70 in Selma, North Carolina.The pump station includes
t1,264 linear feet of 8" PVC force main that connects to the existing 16" Pine Level force main under US Hwy 70,
which connects to the South Selma Regional Pump Station (permit number WO0043778).The gravity system feeding
into Pump Station 4 was permitted and approved through the project 'Eastfield Crossings—Providence Boulevard',
permit number W00043120. Pump Station 4 is being permitted with zero flow since all upstream flows are anticipated
to be permitted within the next 10 years.
Please note that with the Fast Track Sewer System Extension Application, Section II-2,this is labeled as a Proposed
(New Permit)but technically it is replacing/upgrading the existing pump station 4 that is currently in operation. The
Town of Selma is unable to find the permit number for the existing pump station 4.
Existing Pump Station 4 is currently receiving 15,000 GPD of effluent per the Town of Selma and this flow will be
diverted to the new Pump Station 4 day 1 prior to existing pump station 4 going offline.
Should you have any questions regarding this project or require additional information, please do not hesitate to
contact me at 919-578-9000.
Sincerely,
Bohler Engineering
40W
Charles Yowell, PE
Principal
www.BohlerEngineering.com

NC Dept of Environmental Quality
APR 2 4 2023 State of North Carolina
DWR Department of Environmental Quality
Raleigh Regional Office Division of Water Resources
Division of Water Resources FAST TRACK SEWER SYSTEM EXTENSION APPLICATION
FTA 06-21 &SUPPORTING DOCUMENTATION
Application Number: WiP001 ,3 0 (to be compleled by DWR)
All items must be completed or the aimlication will be returned
I. APPLICANT INFORMATION:
I. Applicant's name: T wn of Selma(company,municipality,HOA,utility,etc.)
2. Applicant type: ❑Individual ❑Corporation ❑General Partnership ❑Privately-Owned Public Utility
❑Federal ❑State/County ®Municipal ❑Other
3. Signature authority's name:Todd Young per 15A NCAC 0 .01 b)
Title: Water/Sewer Collections&Distribution Superintendent
4. Applicant's mailing address: 114 North Raiford St
City: Selma State:NC Zip:27576-_
5. Applicant's contact information:
Phone number:[phone] Email Address:-ty_oung(yselma-nc.com
I1. PROJECT INFORMATION:
1. Project name:Eastfield Pump Station 4
2. Application/Project status: ®Proposed(New Permit) ❑Existing Permit/Project
If a modification,provide the existing permit number:WQ00 and issued date:
For modifications,also attach a detailed narrative description as described in Item G of the checklist.
If new construction,but part of a master plan,provide the existing permit number:WQ00
3. County where project is located:Johnston
4. Approximate Coordinates(Decimal Degrees):Latitude: 5.51906° Longitude:78. 292'
5. Parcel ID(if applicable): 2 1414-44-1722(or Parcel ID to closest downstream sewer)
III. CONSULTANT INFORMATION:
1. Professional Engineer:Paul Asche.PE License Number:049213
Firm:Bohler Eneincering NC,PLLC
Mailing address:4130 Parklake Avenue Suite 130
City:Raleigh State:NC Zip:27612-4462
Phone number:(2&578-9000 Email Address:paschenbohlereng corn
IV. WASTEWATER TREATMENT FACILITY(WWTF)INFORMATION:
1. Facility Name:CJ RW WTF Permit Number:NCO030716
Owner Name:Johnston Countv
V. RECEIVING DOWNSTREAM SEWER INFORMATION:
I. Permit Number(s): WQ0043778-South Selma Re Tonal Pum Station and Foreemain
2. Downstream(Receiving)Sewer Information: 16 inch O Gravity ® Force Main
3. System Wide Collection System Permit Number(s)(if applicable):WQCS00060
Owner Name(s):Johnston Count
FORM: FTA 06-21
Page 1 of 5

V1. GENERAL REQUIREMENTS
I. If the Applicant is a Privately-Owned Public Utility,has a Certificate of Public Convenience and Necessity been attached?
❑Yes [:]No ®N/A
2. If the Applicant is a Developer of lots to be sold,has a peg eioper's eral; na1 ngrcrmcn,(FORM;DEV)been attached?
❑Yes ❑No ®N/A
3. If the Applicant is a Home/Property Owners'Association,has an lJOA QA0yerationalAgreement(FORM
_:l lOA j and
supplementary documentation as required by I5A NCAC 02T.0115(c)been attached?
❑Yes ❑No ®N/A
4. Origin of wastewater:(check all that apply):
®Residential(Individually Owned) ®Retail(stores,centers,malls) ❑Car Wash
®Residential(Leased) ®Retail with food preparation/service ®Hotel and/or Motels
®School/preschool/day care ®Medical/dental/veterinary facilities ®Swimming Pool/Clubhouse
®Food and drink facilities ❑Church ❑Swimming Pool/Filter Backwash
®Businesses/offices/factories ❑Nursing Home ❑Other(Explain in Attachment)
5. Nature of wastewater: 0%Domestic Q%Commercial 30%Industrial( I SA N{gL 02'1 .0) QU
If Industrial,is there a Pretreatment Program in effect?❑Yes ❑No
6. Has a flow reduction been approved under 15A_NCAC o2*r.01 t 4l 11? [:]Yes ❑No
If Yes.Provide a coPY of flow reduction ay.12roval letter with this apWication
7. Summarize wastewater generated by project:
Establishment Type(see 02T.0114(f)) Daily Design Flow tin No.of Units Flow
gal/ GPD
gal/ GPD
gall GPD
gaU GPD
gal/ GPD
gal/ GPD
Total GPD
a See 15A N '�AC 02T.0I 14(b), td�.(eH I i and(e}(21 for caveats to wastewater design flow rates(i.e.,minimum flow per
dwelling;proposed unknown non-residential development uses;public access facilities located near high public use areas;
and residential property located south or east of the Atlantic Intracoastal Waterway to be used as vacation rentals as defined
in(J.S.42A.-4).
b Per 15A NCAC 02T.0114(c),design flow rates for establishments not identified[in table l 5A NCAC 02T.01141 shall be
determined using available flow data,water using fixtures,occupancy or operation patterns,and other measured data.
8. Wastewater generated by project: 0 GPD(per 02T.01141
Do not include future flows or previously permitted allocations
If permitted flow is zero,please indicate why:
®Pump Station/Force Main or Gravity Sewer where flow will be permitted in subsequent permits that connect to this line.
Please provide supplementary information indicating the approximate timeframe for permitting upstream sewers with flow.
All upstream flows are anticipated to be permitted within tite next 10 years
❑Flow has already been allocated in Permit Number: Issuance Date:
❑Rehabilitation or replacement of existing sewers with no new flow expected
❑Other(Explain):
FORM:FTA 06-21
Page 2 of 5

Vil. GRAVITY SEWER DESIGN CRITERIA(If Applicable)-02T.W & .mD(:(Gravity %e%crs):
1. Summarize gravity sewer to be permitted:
Size(inches) Length(feet) Material
➢ Section Il&Ill of the MDC for Permitting of Gravity Sewers contains information related to design criteria
➢ Section III contains information related to minimum slopes for gravity sewer(s)
➢ Oversizing lines to meet minimum slope requirements is not allowed and a violation of the MDC
VIII. PUMP STATION DESIGN CRITERIA(If Applicable)—02T.0305&MDC(Pulne Stations/Force Mains):
PROVIDE A SEPARATE COPY OF THIS PA E FOR EACH PUMP STATION INCLUDED 1N THIS PROJE
1. Pump station number or name:Eastfield Pump Station 4
2. Approximate Coordinates(Decimal Degrees): Latitude:3 .51906" Longitude:78.3029220
3. Total number of pumps at the pump station:2
3. Design flow of the pump station: 0.720 millions gallons per day(firm capacity)
➢ This should reflect the total GPM for the pump station with the largest pump out of service.
4. Operational point(s)per pump(s): 575 gallons per minute(GPM)at 15.53 feet total dynamic head(TDH)
5. Summarize the force main to be permitted(for this Pump Station):
Size(inches) Length(feet) Material Notes
8 1,247 PVC FM from Pump Station 4 to connection of Pine Level FM(which
eventually connects to South Selma Re Tonal)
If any portion of the force main is less than 4-inches in diameter,please identify the method of solids reduction per
MDCPSFM Section 2.01 C.Lb.❑Grinder Pump ❑ Mechanical Bar Screen ❑Other(please specify)
6. Power reliability in accordance with 15A`y 'AC 02 t ,0305(h)Lll:
® Standby power source or ❑ Standby pump
➢ Must have automatic activation and telemetry- 15A NCAC 02T.0305(h)(1)(B)_
➢ Required for all pump stations with an average daily flow greater than or equal to 15,000 gallons per day
➢ Must be permanent to facility and may not be portable
Or if the pump station has an average daily flow less than 15,000 gallons per day I SA NCACO2T.0305(hx 1)(C):
❑ Portable power source with manual activation,quick-connection receptacle and telemetry-
or
❑ Portable pumping unit with plugged emergency pump connection and telemetry:
➢ Include documentation that the portable source is owned or contracted by the applicant and is compatible with the station.
➢ if the portable power source or pump is dedicated to multiple pump stations,an evaluation of all the pump stations'storage
capacities and the rotation schedule of the portable power source or pump,including travel timeframes,shall be provided
as part of this permit application in the case of multiple station power outage.
FORM:FTA 06-21
Page 3 of 5

1X. SETBACKS&SEPARATIONS—(02B.0200& 15A NCAC 02T.0305(f)):
1. Does the project comply with all separations/alternatives found in 15A NCAC 021 .0;OS gy? ®Yes ❑No
15A NCAC 02T.0305 contains minimum separations that shall be rovided for sewers stems:
Setback Parameter* Separation Required
Storm sewers and other utilities not listed below(vertical) 18 inches
'Water mains(vertical-water over sewer preferred,including in benched trenches) 18 inches
'Water mains(horizontal) 10 feet
Reclaimed water lines(vertical-reclaimed over sewer) 18 inches
Reclaimed water lines(horizontal -reclaimed over sewer) 2 feet
**Any private or public water supply source,including any wells,WS-1 waters of Class 1 or
Class II impounded reservoirs used as a source of drinking water,and associated wetlands. 100 feet
**Waters classified WS(except WS-1 or WS-V),B,SA,ORW,HQW,or SB from normal
high water(or tide elevation)and wetlands associated with these waters(see item IX.2) 50 feet
**Any other stream,lake,impoundment,or ground water lowering and surface drainage
ditches,as well as wetlands associated with these waters or classified as WL. 10 feet
Any building foundation(horizontal) 5 feet
Any basement(horizontal) 10 feet
Top slope of embankment or cuts of 2 feet or more vertical height 10 feet
Drainage systems and interceptor drains 5 feet
Any swimming pools 10 feet
Final earth grade(vertical) 36 inches
➢ If noncompliance with 02T.0 !%)or ,see Section X.I of this application
*15A NCACO2T. 05( )contains alternatives where separations in 02 c 5(Q cannot be achieved. Please check"yes"
above if these alternatives are used and provide narrative information to explain.
**Stream classifications can be identified using the Division's C Ciassification.x%eb a c.
2. Does this project comply with the minimum separation requirements for water mains? ®Yes [:]No ❑N/A
➢ If no,please refer to 15A NCAC 18C.0906(f)for documentation requirements and submit a separate document,
signed/sealed by an NC licensed PE,verifying the criteria outlined in that Rule.
3. Does the project comply with separation requirements for wetlands? ®Yes ❑No ❑N/A
➢ Please provide supplementary information identifying the areas of non-conformance.
➢ Seethe Division's remrnts for situations where separation cannot be met.
➢ No variance is required if the alternative design criteria specified is utilized in design and construction.
4. Is the project located in a river basin subject to any State buffer rules? ®Yes Basin name: ❑No
If yes,does the project comply with setbacks found in the river basin rules per 15A NCAC 0�F3 . ► 0'! ®Yes ❑No
➢ This includes Trout Buffered Streams per 15A NCAC 2B.02(i2
5. Does the project require coverage/authorization under a 404 Nationwide/individual permits ❑Yes ®No
or 401 Water Quality Certifications?
➢ Please provide the permit number/permitting status in the cover letter if coverage/authorization is required.
6. Does project comply with ISA N(:AC 021:0105(cl(6�(additional perm its/certifications)? ®Yes ❑No
Per 15A NCAC 02 OlO51c)(__h directly related environmental permits or certification applications must be being prepared,
have been applied for,or have been obtained.Issuance of this permit is contingent on issuance of dependent permits(erosion
and sedimentation control plans,stormwater management plans,etc.).
7. Does this project include any sewer collection lines that are deemed"high-priority?" ❑Yes ®No
Per 15A tiC AC G2T.0402,"high-priority sewer"means any aerial sewer,sewer contacting surface waters,
siphon,or sewers positioned parallel to streambanks that are subject to erosion that undermines or deteriorates the sewer.
Siphons and sewers suspended through interference/conflict boxes require a variance approval.
➢ If yes,include an attachment with details for each line, including type(aerial line,size,material,and location).
High priority lines shall be inspected by the permittee or its representative at least once every six-months and
inspections documented per 15A NCAC 02T.0403(a)(5)or the permittee's individual System-Wide Collection permit.
FORM:FTA 06-21
Page 4 of 5

X. CERTIFICATIONS:
1. Does the submitted system comply with 15A NQA( WI,the L4i 'mum esien C'ri,eriiI fo;t 'errn_j ine of fum, tatis�ns
and Force Mains latest%mion).and the Gra%itti Sewer Minimum Design riterie latest yq i n as applicable?
®Yes ❑No
If no, for projects requiring a single variance, complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Approval of the request will be issued
concurrently with the approval of the Dermit, and iprogects reouirine a variance aRvrovall may be subject to ]longer
review times.-For vrojects r uirin two or more variances or where the variance is determined b the Division to be a
i nificant portion of the iproiect,the full technical review is re uired.
2. Professional Engineer's Certification:
I, Paul Asche.PE ,attest that this application for Eastfield PumpStation 4
(Professional Engineer's name from Application Item 111.1.) (Project Name from Application Item 11.1)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications,engineering calculations,and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
'� !J)Utum Ueygn_ ' 'r i fqr sits Stssers tlatest.�),and the�iimum i)esig I rtcr the Fast-1 rack
Cr is fs.[._ P unlit&
ifP ..Slailsntrd rc, Gins!latest Grsion), Although other professionals may have developed certain portions of this
submittal package, inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE — In accordance with General Statutes 143-215.6A and 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000,as well as civil penalties up to$25,000 perviolation.Misrepresentation ofthe application
information,including failure to disclose any design non-compliance with the applicable Rules and design criteria,may subject
the North Carolina-licensed Professional Engineer to referral to the licensing board.(2) NCAC 56,0701)
,__..._..._......_...... _._........_.............._......
North Carolina Professional Engineer's seal,signature,and date:
i
CA
? o f'ss oo`�yy
I aq '��
SEAL 1
049213
I F
................................................._......-.........
t
3. Applicant's Ce ' ati er 15A N C 02T.0106(b):
1>— attest that this application for Eastfield Pump Station 4
(Signature uth ame from Application Item 1 3.1 (Project Name from Application Item 11.1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included,this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non-discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties,injunctive relief,and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, this application
package will be returned to me as incomplete.
NOTE - In accordance with General Statutes i4 -? LAA and I ,??-215,013, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000 as well as civil penalties up to$25,000 per violation.
Signature
- _ Uatc:
FORM:FTA 06-21
Page 5 of 5

r
NC Dept o1 1✓nvlronmCu� �c.... .
Raleigh Regio a10i ice
tate of North Carolina
Department of Environmental Quality
�►' Division of Water Resources
Wk
DKISIon of 1VAter Resources Flow Tracking for Sewer Extension Applications
(FTSE 10-18)
Entity Requesting Allocation: Town of Selma
Project Name for which flow is being requested: Eastfield Pump Station 4
More than one FTSE pray be required for a single project if t/re owner of the WWTP is not responsible for all pump
stations along the route of the proposed wastewaterflow.
1. Complete this section only if you are the owner of the wastewater treatment plant.
a. WWTP Facility Name: Central Jounston County Regina] Wastewater Facility _
b. WWTP Facility Permit#: NCO030716
All flows are in MGD
c. WWTP facility's permitted flow 9.5
d. Estimated obligated flow not yet tributary to the WWTP 2.3909
e. WWTP facility's actual avg. flow 6.741
f. Total flow for this specific request 0
g. Total actual and obligated flows to the facility 9.1321
h. Percent of permitted flow used 71% actual,96.1%w/paper
II. Complete this section for each pump station you are responsible for along the route of this proposed
wastewater flow.
List pump stations located between the project connection point and the WWTP:
(A) (Q) (C) (D)=(B+C) (E)=(A-D)
Design Obligated,
Pump Pump Average Approx. Not Yet Total Current
Station Station Firm Daily Flow** Current Tributary Flow Plus
(Name or Permit Capacity,* (Firm/pf), Avg. Daily Daily Flow, Obligated Available
Num berl No. MGD MGD Flow,MGD MGD Flow Capacity***
South Selma
_Regional 43778 0 0 0 0 0 _ 0
SelmaEQ 41331 3.456 2.022 1.177 0.006 1.186 0.840
Buffalo
Creek 40380 6.912 2.765 2.289 0.239 2.528 0.237
*The Firm Capacity(design flow)of any pump station is defined as the maximum pumped flow
that can be achieved with the largest pump taken out of service.
**Design Average Daily Flow is the firm capacity of the pump station divided by a peaking factor
(po not less than 2.5,per Section 2.02(A)(4)(c)of the Minimum Design Criteria.
***A Planning Assessment Addendum shall be attached for each pump station located
between the project connection point and the WWTP where the Available Capacity is<0.
Downstream Facility Name(Sewer): South Selma Regional Pump Station
Downstream Perm it Number: W 0043778
Page 1 of 6
FTSE 10-18

Ili.Certification Statement:
I A,If l 1 /41 "'%4 N'd certify to the best of my knowledge that the addition of
the volume of wastewater to be permitted in this project has been evaluated along the route to the receiving
wastewater treatment facility and that the flow from this project is not anticipated to cause any capacity
related sanitary sewer overflows or overburden any downstream pump station en route to the receiving
treatment plant under normal circumstances, given the implementation of the planned improvements
identified in the planning assessment where applicable. This analysis has been performed in accordance
with local established policies and procedures using the best available data. This certification applies to
those items listed above in Sections I and II plus all attached planning assessment addendums for which I
am the responsible party. Signature of this form certifies that the receiving collection system or treatment
works has adequate capa ity to transport and treat the proposed new wastewater.
3�� �11?12 3
Signings Official Signs Lure Dale
�-F4-,,yr DE ply 7-ow It 1411,.•. aver
Title of Signing Official
Page 2 of 6
FTS E 10-18

PLANNING ASSESSMENT ADDENDUM (PAA)
Submit a planning assessment addendum for each pump station listed in Section 11 where Available Capacity is<
0.
Pump Station(Name or Number):
Given that:
a. The proportion and amount of Obligated,Not Yet Tributary Daily Flow(C)accounts for
and MGD of the Available Capacity(E) in Pump Station
;and that
b. The rate of activation of this obligated,not yet tributary capacity is currently approximately
MGD per year;and that
c. A funded Capital Project that will provide the required planned capacity,namely
is in design or under construction with
planned completion in ;and/or
d. The following applies:
Therefore:
Given reasonably expected conditions and planning information, there is sufficient justification to allow
this flow to be permitted, without a significant likelihood of over-allocating capacity in the system
infrastructure.
I understand that this does not relieve the collection system owner from complying with G.S. 143-
215.67(a) which prohibits the introduction of any waste in excess of the capacity of the waste disposal
system.
Signing Official Signature Date
Page 3 of 6
FTSE 10-18

aarff0 ruumaaa y iare�
4'
Memo �2E(Lr16(u"uawuo.rrnu_jJu ldaQ DN
To: Division of Water Resources/NC DEQ Regional Resource Office
From: Mark McDonnell
Date: 4/4/2023
Re: Flow Tracking for Sewer Extension Applications
Enclosed, please find - Flow Tracking for Sewer Extension Applications.
Please let us know if you have any questions.
Thank you,
lisha Pearson - Administrative Assistant
Adventure Development, LLC
Eastfield Associates, LLC
101 South Raiford Street, Suite 200, Selma NC 27576*Office [phone] *Fax[phone]

iVC Dept(-,;'Lr)vrrppmental Quality
APR 2 4 2023
Memo Raleigh Regional Office
To: Division of Water Resources/NC DEQ Regional Resource Office
From: Mark McDonnell
Date: 4/20/2023
Re: Flow Tracking for Sewer Extension Applications
Enclosed, please find - Flow Tracking for Sewer Extension Applications (signatures that
were missed the first time) and checks.
Please let us know if you have any questions.
Thank you,
lisha Pearson - Administrative Assistant
Adventure Development, LLC
Eastfield Associates, LLC
101 South Raiford Street,Suite 200,Selma NC 27576'Office(919) 965-5661 * Fax[phone]

NC Dept of EnW0nr11ental Quality
APR 2 4 2023
X. CERTIFICATIONS:
1. Does the submitted system comply ttith ISA NCAC 02T,the Mirl rr;,IJm lksjQn(riter'a liar 1 i
and force Mains latest version)_and the Gra%,k1Sc%%er Minimum Desyn Criteria It atesi version as applicale
®Yes ❑No
If no, for projects requiring a single variance. complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for reties to the Central Office. Approval of the request will be issued
concurrently with the approval of IhIE permit,and projects requiring a variance approval may be subiect to longer
review times.For protects requiring rApr or more variances or where the variance Is determined by the Division to be a
slenlficant portion of the protect,the full technical review Is required.
2. Professional Engineer's Certification:
I, Paul Asche. PE attest that this application for Eastfield Commercial Pumn Station
(Professional Engineer's name from Application Item ill 1 (Pro)ect Name from Application Item II 1)
has been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specifications,engineering calculations,and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance%%ith the applicable regulations,
1iInemUrn Dcsizn(rllerla Inr()rlvlu ' i� i .t �('r- ,,m .and the Minimum C)e,.iAp(pl�fl�t�i L'trl,ut•IrAck Pear`.1IIInY
�2.Pumn Ntat,_igns and Forth Nlain�liatc 1 \_sator). Although other professionals may have developed certain portions ofthis
submittal package, inclusion of these materials under m) signature and sea] signifies that I hat a reviewed this material and
have judged it to be consistent ttith the proposed design.
NOTE In accordance with General Statutes 143-215.6A and 143-215.613, any person ttho knotingly makes any false
statement, representation, or certification in an) application package shall be guilty of a Class 2 misdemeanor, %which may
include a fine not to exceed S 10,000,as well as civil penalties up to S25,000 per violation.Misrepresentation of the application
information.including failure to disclose any design non-compliance with the applicable Rules and design criteria,may subject
the North Carolina-licensed Professional Engineer to referral to the licensing board.(21 NCAC 56.0701)
North Carolina Professional Engineer's seal,signature.and date: � CAfjOZ/
� Q�FESSlp�<
I SEAL
0492t3
7 "+GINtst",
PSC,
3. Applicant's Ce ion 15A NC C 02T.0I06(b):
Z
1, 7 attest that this application for Eastfield Commercial Pump Station
(Sagnatu Application Item 13) (Project Name from Application Item 11 1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included,this application package is subject to being returned as incomplete. 1 understand that any
discharge of tvastetwater from this non-discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties,injunctive relief,and/or criminal prosecution. l will make no claim against the Division
of Water Resources should a condition of this permit be violated. 1 also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included,this application
package will be returned to me as incomplete.
NOTE In accordance with General Statutes 1.43-215,6A and 14 I S.bi3, any person who knowingly makes any false
statement,representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000 as well as civil penalties up to$23.000 per violation.
1 �Signature: Date;
FORM: FTA 06-21 Page 5 of 5

NC D -
Quality
APR 2 4 2023
Raleigh RegioJja1 Office
CHECK REQUEST
PAYING CO./PROPERTY: Eastfield Associates, LLC
DATE REQUESTED: 4/13/2023 DATE NEEDED: ASAP
AMOUNT: $480.00
PAYABLE TO: NC DEQ
REASON/DESCRIPTION: Eastfield Commercial Pump Station
AP ENTRY:
APPROVAL: Per Mark, Attached
ENTERED: BY:
SPECIAL INSTRUCTIONS:

X. CERTIFICATIONS:
1. Does the submitted system comply with IJAJ&At 02T.the Minimum Design Criteria 1orJhtpgm1j1jpg,of Pump Station,
and Force Mains tlatcso crsion> mid the Gravity Server Minimum DrIiiLn Criteria Llatest%ersilm as applicable?
® Yes ❑No
If no. for projects requiring a single variance. complete and submit the Variance/Alternative Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. Acurpvai or the regue3f will be Issued
concurrently with the anaroval_o-the Permit,_and Projects requiring a varianSe anurQval-may be subject to lonver
review times.For Projects regnirine two or more variances or where the variance Is_determined_by the Division to be a
sisinificant Portion of the Proiect,the full technical review is required.
2. Professional Engineer's Certification:
1, Paul Asche.PE attest that this application for E l field Industrial Park Pump Station
(Professional Engineer's name from Application Item III I) (Project Name from Application Item 11 l)
bus been reviewed by me and is accurate, complete and consistent with the information supplied in the plans,
specilications,engineering calculations,and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations.
tilinimum Design(Lnieria fvr Qrpviu t+s;W(,tss>� _"!<<1,and the Mtntnt►:.•n Design Criteria fol{)k fag-IrarLPe>r7tltir>L
La Pump Stations and Force INelni()(nest version Although other professionals may have developed certain portions of this
submittal package,inclusion of these materials under my signature and seal signifies that I have reviewed this material and
have judged it to be consistent with the proposed design.
NOTE In accordance with General Statutes 143-215.6A and 143.215.613, any person who knowingly makes any false
statement, representation, or certification in any application package shall be guilty of a Class 2 misdemeanor, which ma)
include a tine not to exceed S10,000,as well as civil penalties up to S25,000 per violation.Misrepresentation of the application
information.including failure to disclose any design non-compliance with the applicable Rules and design criteria,may subject
the North Carolina-licensed Professional Engineer to referral to the licensing board.(21 NCAC 56.070))
North Carolina Professional Engineer's seal,signature,and date: �qN CAR04
4oQ�FEsslo, I
SEAL i
049213
G� M P5G
3. Applicant's C ' do r SA 02T.W 06(b):
I, ,attest that this application for Eastfseld Industrial Park Pump Station
(Signature Autho dame from Application Item 13) Project Name from Application Item 11 1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
I understand that if all required parts of this application are not completed and that if all required supporting documentation
and attachments are not included,this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non-discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties,injunctive relief,and/or criminal prosecution. I will make no claim against the Division
of water Resources should a condition of this permit be violated. I also understand that if all required pans of this application
package are not completed and that if all required supporting information and attachments are not included,this application
package will be returned to me as incomplete_
NOTE In accordance with General Statutes 143.215.6A and 143.215.613, any person who knowingly makes any false
statement, representation,or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10.000 as well as civil penalties up to$25.000 per violation.
Signature: Date:
l3 zj
FORM:1 i'A 06-21 Page 6 of 5

NC Dept of�
t
APR 2 4 2023
Raleigh Regional Office
CHECK REQUEST
PAYING CO./PROPERTY: Eastfield Associates, LLC
DATE REQUESTED: 4/13/2023 DATE NEEDED: ASAP
AMOUNT: $480.00
PAYABLE TO: NC DEQ
REASON/DESCRIPTION: Eastfield Industrial Park Pump Station C apLutiN�
AP ENTRY:
APPROVAL: Per Mark, Attached
ENTERED: BY:
SPECIAL INSTRUCTIONS:

X. CERTIFICATIONS:
i. Does the submitted system comply with UA N[AC'u21,the Minir+unl l)W_t=ULfo,the Permig=drgM
and r Mai s % is iZZii11t
_Il 11 y �_ 1),and the(;rtt�'It) Seu r, tnimum Dcs�n ritcrj!tlaiesl�crsiew as applicable?
®Yes ❑No
If no, for projects requiring a single variance,complete and submit the Vari ance/A Item stive Design Request application
(VADC 10-14) and supporting documents for review to the Central Office. ADRMvitl of tht reauest wal he issued
90111111HEE11111111Y withapproval e manit and Prolccbrin a variance u o
longtr
more-varktices or ere the variance 11 determined by the Division 12 be 4
sknificont g9rflort ofthe project,the full tee
buical
2. Professional Engineer's Certification:
I, Paul Asche_PR attest that this application for 4
r Profeumnal Engmcw's now t}om Application item Ill I + (Project Name from Application Item(I.1)
has been reviewed by me and Is accurate, complete and consistent with the Information supplied In the plans,
specifications,engineering calculations,and all other supporting documentation to the best of my knowledge. I further
attest that to the best of my knowledge the proposed design has been prepared in accordance with the applicable regulations,
Minimum Iksirrn['r;1e for Graz itti Severs a latest t iLs n,turd the t n ruer�a forIhe fast-tract,Perminitt¢
a1LP.i1IDD�atitxtc n Z11il..Ull�.a..�QS,
=a_df nrcc Mains �, i Although other professionals may have developed certain portions ot'this
submittal package, inclusion of these materials under my signature and sea] signifies that 1 have reviewed this material and
have judged it to be consistent with the proposed design.
MOTE - In accordance with General Statutes 143-215.6A and 143-215.6B, any person who knowingly makes any false
statement,representation,or certification in any application package shall be guilty of a Class 2 misdemeanor, which may
include a fine not to exceed$10,000,as well as civil penalties up to S25,000 per violation.Misrepresentation of the application
information,including failure to disclose any design non-compliance with the applicable Rules and design criteria,may subject
the North Carolina-licensed Professional Engineer to referral to the licensing board.(21 NCAC 56.0701)
North Carolina Professional Engineer's seal,signature,and date: CARO
�FESS tT /
SEAL
049213
G� M
3. Applicant's Cc ' i 15A ' C 02T.0106(b):
I,— attest that this application for Eastftld Pumr?Station 4
(Siaaat utha from AppliWZ liem 13) (Project Name from Application Item!1 1)
attest that this application has been reviewed by me and is accurate and complete to the best of my knowledge.
1 understand that if all required parts of this application are not completed and that If all required supporting documentation
and attachments are not included,this application package is subject to being returned as incomplete. I understand that any
discharge of wastewater from this non-discharge system to surface waters or the land will result in an immediate enforcement
action that may include civil penalties,injunctive relief,and/or criminal prosecution. I will make no claim against the Division
of Water Resources should a condition of this permit be violated. I also understand that if all required parts of this application
package are not completed and that if all required supporting information and attachments are not included, this application
package will be returned to me as incomplete.
NOTE In accordance with General Statutes 4 - y person who knowingly makes any false
13 215.GA and 43.21 S.t�. an
statement, representation, or certifyation in any application packages II be guilty of a Class 2 misdemeanor, which may
include a fine not to ex 10, as well as civil penalties to a25 per violation.
/ " )/0
Signature:_ Date 11123
�- ---
FORM:FTA 06-21
Page 5 of 5

t
CDeptnf
APR 2 4 2023
Raleigh Regional office
CHECK REQUEST
PAYING CO./PROPERTY: Eastfield Associates, LLC
DATE REQUESTED: 4/13/2023 DATE NEEDED: ASAP
AMOUNT: $480.00
PAYABLE TO: NC DEQ
REASON/DESCRIPTION: Eastfield Pump Station 4
AP ENTRY:
APPROVAL: Per Mark, Attached
ENTERED: BY:
SPECIAL INSTRUCTIONS:

From: Wild,Elaine
To: omcdanieWbselma-nc.com;cvowell(d)bohlerena.com;tvounaCa selma-nc.com; oascheCla bohlerena.com
Cc: Smith,J Chris; Pasha,Tanvir;Wilson.Susan A;Simpson,Richard
Subject: Eastrield Commercial Pump Station,Eastrield Pump Station 4,&Eastrield Industrial Park Pump
Station_Incomplete Application Return
Date: Friday,January 26,2024 3:36:00 PM
Attachments: imaae001.pnna
imaae003.ona
Dear Phillip, Charles,Tood, and Paul,
Emails were sent on May 31, 2023, indicating that additional information was needed for the
Eastfield Commercial Pump Station, Eastfield Pump Station 4, and Eastfield Industrial Park Pump
Station projects in order to further process the applications for a Fast Track Sewer Extension
Permits. As of today's date, the Division of Water Resources has not received all of the additional
information requested for these projects, therefore, in accordance with 15A NCAC 02T .0107, the
project application is being returned as incomplete. If you wish to pursue permitting for this project,
please submit a completed application accompanied by a new application fee.
15A NCAC 02T .0107 Staff Review and Permit Preparation states:
• "(2) (e) If an application is accepted and later found to be incomplete, the applicant shall be
advised how the application or accompanying supporting information may be modified to
make it complete. The staff shall advise the applicant:
(2) if all required information is not submitted within 30 days, the project will be
returned as incomplete. Any resubmittal of a returned application shall be accompanied
with a new application fee."
*Please note that the fee for fast track sewer extension permits has increased to$600 as of
October 3, 2023[as stipulated in the 2023 House Appropriations Act, House Bill 259, Water
Quality and Storm water Fees, Section 12.14(a)].
Sewer Extension Permitting I INC DEQ
Sincerely,
Elaine Wild
Environmental Engineer
Division of Water Resources- Raleigh Regional Office
North Carolina Department of Environmental Quality
919.791.4254 Office
elaine.wild(@deq.nc.gov

J
E
INpa.NMnl d(nrxmmenW OuaM/�
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
Sewer Extension Permitting I NC DEQ
subchapter t rules.pdf(state.nc.us)
From: Smith,J Chris
Sent: Monday,June 12, 2023 12:06 PM
To: [e-mail]
Subject: FW: Fast Track Sewer System Extension Permit Applications-Town of Selma Eastfield
Commercial Pump Station, Eastfield Pump Station 4, Eastfield Industrial Park Pump Station
Mr. Wall,
Please see the message below sent to Town of Selma staff and Bohler engineering on May 31, 2023.
DEQ is updating its email addresses to @deq.nc.gov in phases from May 1st to June 9th. Employee
email addresses may look different, but email performance will not be impacted.
J. Chris Smith (he/him/his)
Environmental Specialist, Raleigh Regional Office DWR
North Carolina Department of Environmental Quality
Office:[phone]
chris.smithOdeq.nc.gov
Q:>
NORTH CAROLINA
Department of Environmental Quality
Email correspondence to and from this address is subject to the North
Carolina Public Records Law and may be disclosed to third parties.
North_Carolina's_Riparian_Buffer_Protection_Program
From: Smith,J Chris
Sent: Wednesday, May 31, 2023 2:26 PM
To: tvoung(@selma-nc.com; pasche(@bohlereng.com
Subject: Fast Track Sewer System Extension Permit Applications-Town of Selma Eastfield
Commercial Pump Station, Eastfield Pump Station 4, Eastfield Industrial Park Pump Station

Todd Young and Paul Asche,
There are multiple incomplete and inaccurate items on all 3 of these applications.
Some of the issues include:
• No cover letters were provided
• The applications are not signed by the applicant
• The Flow Tracking forms are not signed by a signatory authority for any of the downstream
pump stations
• The Flow Tracking forms are not signed by a signatory authority for the Central Johnston
County Regional Wastewater Facility
• The Flow Tracking forms list pump stations with no firm capacity or available capacity
• No narratives were provided
• No maps were provided
• Specific to the Eastfield Industrial Park Pump Station application—it was not made clear
whether a 401 Water Quality Certification was required and this entire item was not
addressed in the cover letter because no cover letter was provided
Please go through the instructions. Provide all required information. Make sure you go through the
entire application and complete every item and submit the revised application within 30 calendar
days.
Once fully completed you can submit the revised applications via email to me at:
chris.smithPdeq.nc.gov
Please note that 15A NCAC 02T .0106 Submission of Permit Applications states:
"(b) Permit applications shall be signed as follows:
(4) in the case of a municipal, state, or other public entity, by either an executive
officer, elected official in the highest level of elected office, or other authorized employee.
(c) Delegation of authority to sign permit applications to other authorized employees or
any employee in a specific position shall be provided in writing to the Division and signed by an
authorized person pursuant to Paragraph (b) of this Rule.The delegation may be for a specific permit
application or for certain or all types of water quality permits. The letter shall identify the extent of
delegation."
15A NCAC 02T.0107 Staff Review and Permit Preparation states:
"(2) (e) If an application is accepted and later found to be incomplete, the applicant shall be
advised how the application or accompanying supporting information may be modified to make it
complete. The staff shall advise the applicant:
(2) if all required information is not submitted within 30 days, the project will be
returned as incomplete. Any resubmittal of a returned application shall be accompanied
with a new application fee."
Best,
Email correspondence to and from this address may be subject to the North Carolina Public Records Law and may be disclosed to third
parties by an authorized state official.